• RN Utilization Management

    Humana (Honolulu, HI)
    …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
    Humana (10/04/24)
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  • Utilization Review Clinician…

    Centene Corporation (Honolulu, HI)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (09/22/24)
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  • Behavioral Health Case Management

    Centene Corporation (Honolulu, HI)
    …Clinical Mental Health Counselor (LCMHC):** **Required Licensed Psychologist** **Required Licensed Registered Nurse ( RN )** **Required Licensed Clinical ... behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization...level independent or non-independent license is required OR an RN with a behavioral health background: +… more
    Centene Corporation (09/14/24)
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  • HMSA Intake Precert Care Manager - Remote Hawaii

    Magellan Health Services (Honolulu, HI)
    …- Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN . Minimum 2 years experience post degree in healthcare,...time management and communication skills. Knowledge of utilization management procedures, mental health and substance… more
    Magellan Health Services (08/23/24)
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  • Payment Integrity Clinician

    Highmark Health (Honolulu, HI)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
    Highmark Health (09/27/24)
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